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NTERPRETING FINDINGS AND FORMULATI
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NG DIFFERENTIAL DIAGNOSES 5TH EDITIO
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N, MARY JO GOOLSBY, LAURIE GRUBBS ISB
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N-10; 1719645930 / ISBN-13;978-1719645935
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,Chapter;1.;Assessment;and;Clinical;Decision-Making:;Overview
Multiple;Choice
Identify;the;choice;that;best;completes;the;statement;or;answers;the;question.
1. Which;type;of;clinical;decision-making;is;most;reliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
2. Which;of;the;following;is;false?;To;obtain;adequate;history,;health-care;providers;must;be:
A. Methodical;and;systematic
B. Attentive;to;the;patient’s;verbal;and;nonverbal;language
C. Able;to;accurately;interpret;the;patient’s;responses
D. Adept;at;reading;into;the;patient’s;statements
3. Essential;parts;of;a;health;history;include;all;of;the;following;except:
A. Chief;complaint
B. History;of;the;present;illness
C. Current;vital;signs
D. All;of;the;above;are;essential;history;components
4. Which;of;the;following;is;false?;While;performing;the;physical;examination,;the;examiner;must;be;abl
e;to:
A. Differentiate;between;normal;and;abnormal;findings
B. Recall;knowledge;of;a;range;of;conditions;and;their;associated;signs;and;symptoms
C. Recognize;how;certain;conditions;affect;the;response;to;other;conditions
D. Foresee;unpredictable;findings
5. The;following;is;the;least;reliable;source;of;information;for;diagnostic;statistics:
A. Evidence-based;investigations
B. Primary;reports;of;research
C. Estimation;based;on;a;provider’s;experience
D. Published;meta-analyses
6. The;following;can;be;used;to;assist;in;sound;clinical;decision-making:
A. Algorithm;published;in;a;peer-reviewed;journal;article
B. Clinical;practice;guidelines
C. Evidence-based;research
D. All;of;the;above
7. If;a;diagnostic;study;has;high;sensitivity,;this;indicates;a:
A. High;percentage;of;persons;with;the;given;condition;will;have;an;abnormal;result
B. Low;percentage;of;persons;with;the;given;condition;will;have;an;abnormal;result
C. Low;likelihood;of;normal;result;in;persons;without;a;given;condition
D. None;of;the;above
, 8. If;a;diagnostic;study;has;high;specificity,;this;indicates;a:
A. Low;percentage;of;healthy;individuals;will;show;a;normal;result
B. High;percentage;of;healthy;individuals;will;show;a;normal;result
C. High;percentage;of;individuals;with;a;disorder;will;show;a;normal;result
D. Low;percentage;of;individuals;with;a;disorder;will;show;an;abnormal;result
9. A;likelihood;ratio;above;1;indicates;that;a;diagnostic;test;showing;a:
A. Positive;result;is;strongly;associated;with;the;disease
B. Negative;result;is;strongly;associated;with;absence;of;the;disease
C. Positive;result;is;weakly;associated;with;the;disease
D. Negative;result;is;weakly;associated;with;absence;of;the;disease
; 10.;Which;of;the;following;clinical;reasoning;tools;is;defined;as;evidence-
based;resource;based;on;mathematical;modeling;to;express;the;likelihood;of;a;condition;in;select;situa
tions,;settings,;and/or;patients?
A. Clinical;practice;guideline
B. Clinical;decision;rule
C. Clinical;algorithm
D. Clinical;recommendation
, Answer;Section
MULTIPLE;CHOICE
1. ANS:; ; B
Croskerry;(2009);describes;two;major;types;of;clinical;diagnostic;decision-
making:;intuitive;and;analytical.;Intuitive;decision-making;(similar;to;Augenblink;decision-
making);is;based;on;the;experience;and;intuition;of;the;clinician;and;is;less;reliable;and;paired;with;fai
rly;common;errors.;In;contrast,;analytical;decision-
making;is;based;on;careful;consideration;and;has;greater;reliability;with;rare;errors.
PTS: 1
2. ANS:; ; D
To;obtain;adequate;history,;providers;must;be;well;organized,;attentive;to;the;patient’s;verbal;and;non
verbal;language,;and;able;to;accurately;interpret;the;patient’s;responses;to;questions.;Rather;than;read
ing;into;the;patient’s;statements,;they;clarify;any;areas;of;uncertainty.
PTS: 1
3. ANS:; ; C
Vital;signs;are;part;of;the;physical;examination;portion;of;patient;assessment,;not;part;of;the;health;hist
ory.
PTS: 1
4. ANS:; ; D
While;performing;the;physical;examination,;the;examiner;must;be;able;to;differentiate;between;norm
al;and;abnormal;findings,;recall;knowledge;of;a;range;of;conditions,;including;their;associated;signs;a
nd;symptoms,;recognize;how;certain;conditions;affect;the;response;to;other;conditions,;and;distingui
sh;the;relevance;of;varied;abnormal;findings.
PTS: 1
5. ANS:; ; C
Sources;for;diagnostic;statistics;include;textbooks,;primary;reports;of;research,;and;published;meta-
analyses.;Another;source;of;statistics,;the;one;that;has;been;most;widely;used;and;available;for;appli
cation;to;the;reasoning;process,;is;the;estimation;based;on;a;provider’s;experience,;although;these;ar
e;rarely;accurate.;Over;the;past;decade,;the;availability;of;evidence;on;which;to;base;clinical;reasoni
ng;is;improving,;and;there;is;an;increasing;expectation;that;clinical;reasoning;be;based;on;scientific;e
vidence.;Evidence-
based;statistics;are;also;increasingly;being;used;to;develop;resources;to;facilitate;clinical;decision-
making.
PTS: 1
6. ANS:; ; D
To;assist;in;clinical;decision-making,;a;number;of;evidence-
based;resources;have;been;developed;to;assist;the;clinician.;Resources,;such;as;algorithms;and;clinic
al;practice;guidelines,;assist;in;clinical;reasoning;when;properly;applied.